title: MR-guided facet joint injection therapy using an open 1.0-T MRI system: an outcome study.
abstract: OBJECTIVE
  To evaluate the accuracy, safety and efficacy of magnetic resonance imaging (MRI)-guided facet joint injection therapy using a 1.0-T open MRI.
  
  
  METHODS
  One hundred and sixty-six facet joint blocks in 45 patients with lower back pain were performed under MR fluoroscopic guidance using a proton-density-weighted turbo-spin-echo sequence. An in-room monitor, wireless MR-mouse for operator-controlled multiplanar navigation, a flexible surface coil and MR-compatible 20-G needle were used. Clinical outcome was evaluated by questionnaire before intervention and after 1 week, 3, 6 and 12 months using a numerical visual analogue scale (VAS).
  
  
  RESULTS
  All facet joint blocks were considered technically successful with distribution of the injectant within and/or around the targeted facet joint. No major complications occurred. The final outcome analysis included 38 patients. An immediate effect was reported by 63 % of the patients. A positive mid-/long-term effect was seen in 13 patients (34 %) after 6 months and in 9 patients (24 %) after 12 months. Mean VAS was reduced from 7.1 ± 1.7 (baseline) to 3.5 ± 2.2, 4.1 ± 3.0, 3.8 ± 2.9 and 4.6 ± 2.9 at 1 week, 3, 6 and 12 months (P < 0.01).
  
  
  CONCLUSIONS
  MR-guided facet joint injection therapy of the lumbosacral spine is accurate, safe and efficient in the symptomatic treatment of lower back pain.
authors.affiliation: Charité Universitätsmedizin Berlin, Department of Radiology, Augustenburger Platz 1, 13353, Berlin, Germany, patrick.freyhardt@charite.de.
authors.forename: Patrick
authors.initials: P
authors.lastname: Freyhardt
authors.forename: Tony
authors.initials: T
authors.lastname: Hartwig
authors.forename: Maximilian
authors.initials: M
authors.lastname: De Bucourt
authors.forename: Martin
authors.initials: M
authors.lastname: Maurer
authors.forename: Diane
authors.initials: D
authors.lastname: Renz
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gebauer
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Ulf K M
authors.initials: UK
authors.lastname: Teichgräber
authors.forename: Florian
authors.initials: F
authors.lastname: Streitparth
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D004360:Drug Therapy, Computer-Assisted; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D017116:Low Back Pain / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008161:Lumbosacral Region / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D016896:Treatment Outcome; D014584:User-Computer Interface; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging / Q000473:pathology*
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine